Trivial

A 68 year old lady presents with a worsening headache for 2 weeks, and mild disorientation for 2 days. There is no history of trauma.

She was diagnosed with diabetes mellitus 10 years ago, which is uncomplicated and well controlled on metformin alone.

She is not on any other drugs, and has an unremarkable family history.

Select Relevant Investigations
CT Brain

Performed

There is a large, hyperdense, right-sided subdural collection with signs of recent bleeding. A midline shift of 10 mm is noted.
Lumbar Puncture

Performed

You realize that performing a lumbar puncture might not be a good idea.
X-Ray Skull

Performed

The X-Ray of the skull appears completely normal.
Coagulation Profile

Performed

INR: 1.0 (0.9-1.2)
APTT: 29 sec (25-35)
TT: 12 sec (11-15)

Select Relevant Management
Burr Hole Craniotomy
Mannitol
Aspirin
Conservative Management